Gynecologic Cancer: Risks, Symptoms, Screening and Detection

According to the National Cancer Institute, more than 106,000 women in the United States are expected to be diagnosed with a gynecological cancer in 2023, and more than 32,000 will die from one. September is Gynecologic Cancer Awareness Month, which is a great opportunity to learn the different signs and symptoms of gynecologic cancers, as well as risk factors.

Gynecologic cancers encompass all cancers of the female reproductive system, including the cervix, ovaries, uterus, vagina and vulva. Awareness and early detection remain critically important to ensure the best outcomes for patients.

Gynecologic oncologists are medical doctors with specialized training in treating gynecologic cancers. If cervical, ovarian, uterine/endometrial cancer, vaginal or vulvar cancer is suspected or diagnosed, you should seek care from a gynecologic oncologist.

The 5 Major Categories of Gynecologic Cancer

Cervical Cancer   

Human Papilloma Virus (HPV) infection of the cervix is almost always the cause of cervical cancer, and most cases of cervical cancer are now preventable thanks to the HPV vaccine. The HPV vaccine is available as early as age 9 and is recommended for everyone through age 26, though it is approved for some patients up to age 46.

Women who do not regularly have tests to detect HPV or abnormal cells in the cervix are at increased risk of cervical cancer. Therefore, the best way to find and prevent cervical cancer is to have regular Pap tests (or Pap smears) and HPV tests at intervals recommended by your healthcare provider.

Symptoms of cervical cancer include:

• Abnormal vaginal discharge or bleeding

• Bleeding after vaginal sex

• Unusual vaginal odor

• Pelvic or abdominal pain

Any of these signs or symptoms should be evaluated by gynecologist or by someone who can perform a vaginal examination.

Ovarian Cancer   

There are three types of ovarian cancer in adults, including:

1. Ovarian epithelial cancer, which begins in the tissue covering the ovary, lining of the fallopian tube or the peritoneum

2. Ovarian germ cell tumors, which start in the egg or germ cells

3. Ovarian low malignant potential tumors

There is currently no good screening method for ovarian cancer. See a gynecologist or another qualified healthcare provider if you experience any of these symptoms for more than 2-3 weeks:

• Bloating

• Urinary symptoms (urgency or frequency)

• Pelvic or abdominal pain

• Difficulty eating or feeling full quickly

Schedule regular check-ups with your primary care provider, including pelvic exams in order to help detect ovarian cancer early, and tell your provider if you have a family history of ovarian, endometrial or colon cancer in order to determine if genetic testing may be beneficial. Transvaginal ultrasounds and CA 125 blood tests may be offered to screen people with a high-risk of ovarian cancer due to an inherited genetic syndrome such as Lynch syndrome, BRCA gene mutations or a strong family history of breast and ovarian cancer.

Uterine/Endometrial Cancer 
 

Endometrial cancer, also known as uterine cancer, is the most common gynecologic cancer. Maintaining a healthy weight is one way to lower your risk of endometrial cancer. Obesity, high blood pressure and diabetes may increase the risk of developing endometrial cancer. The use of tamoxifen, a medication used to treat breast cancer, may also increase the risk of developing endometrial cancer.

Early detection may improve the chances that endometrial cancer will be treated successfully. See a gynecologic oncologist or other qualified healthcare provider if you experience unusual vaginal bleeding, spotting or discharge that’s getting worse, occurring between periods or happening after menopause. At menopause, all women should be told about the risks and symptoms of endometrial cancer and are strongly encouraged to report any vaginal bleeding, spotting or discharge to their doctor.

Another type of uterine cancer is uterine sarcoma. It is a rare type of cancer that forms in the uterine muscles or in tissues that support the uterus. Past treatment with radiation therapy to the pelvis can increase the risk of uterine sarcoma.

Vaginal Cancer   

There are two main types of vaginal cancer: squamous cell carcinoma, which forms in the thin, flat cells lining the inside of the vagina, and adenocarcinoma, which begins in the glandular cells lining the inside of the vagina. Older age and having an HPV infection are risk factors for vaginal cancer.

Signs of vaginal cancer include:

• Unusual vaginal bleeding

• Bleeding after vaginal sex

• Pain or problems with urination or bowel movements

• Watery vaginal discharge

• A lump or mass in the vagina

If you experience any of these symptoms, see a gynecologist or another qualified women’s healthcare provider.

Vaginal cancer is also often associated with HPV. The same HPV vaccine used to prevent cervical cancer also helps to prevent vaginal cancer. Routine wellness visits and cervical cancer screenings can sometimes find early invasive vaginal cancer when it is more likely to be successfully treated.

Vulvar Cancer   

Vulvar cancer forms on a woman’s external genitalia, most often affecting the outer vaginal lips. Signs of vulvar cancer or pre-cancer include:

• Chronic itching

• Abnormal bleeding or discharge

• Skin color changes (lighter or darker, red or pink)

• A bump or lump that looks like a wart or ulcer

Any symptoms should be evaluated by a gynecologist or other women’s healthcare provider. While there is no standard screening for vulvar cancer, knowing what to look for can help with early detection. An area on the vulva that looks different than normal, a bump or lump, thickening of the skin of the vulva, or an open sore should be evaluated.

Abnormal cells can grow on the surface of the vulvar skin for a long time. This condition is called vulvar intraepithelial neoplasia (VIN). Because it is possible for VIN to become vulvar cancer, it is important to get an evaluation and treatment.

Risk factors for vulvar cancer include having VIN, HPV infection, and having a history of genital warts.

Gynecologic Cancer Treatment and Care

If you experience any of the symptoms of gynecologic cancer, you should speak with your primary care provider or gynecologist as soon as possible. The Tallahassee Memorial Cancer Center is home to the region’s largest and most advanced gynecologic cancer team.

With three board-certified oncologists highly trained in treating gynecologic cancers, our TMH Physician Partners – Gynecologic Oncology practice takes a team approach to your care, taking you from diagnosis to treatment faster.

Our dedicated team will develop a personalized care plan tailored to your unique needs, with treatments that may include surgery, topical treatments, radiation therapy, chemotherapy, immunotherapy and involvement in clinical trials.